SHH MEDICAL GROUP IDAHO, LLC (NPI# 1972165579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972165579 |
Entity Type | Organization |
Organization Name | SHH MEDICAL GROUP IDAHO, LLC |
Practice Address |
3751 N Cloverdale Rd Boise ID 83713-3610 |
Mailing Address |
Po Box 1176 Meridian ID 83680-1176 |
Practice Telephone | 2083215073 |
Practice Fax Number | 2083760269 |
Mailing Telephone | 2083767298 |
Mailing Fax Number | 2083778310 |
Enumeration Date | 2019-07-03 |
Last Update Date | 2019-07-03 |
Authorized Official Name | JASON FLETCHER (PRESIDENT) |
Authorized Official Telephone | 2083767298 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
AUTUMN RIDGE MEDICAL GROUP | Doing Business As Name - Organization |
Street Address |
3751 N CLOVERDALE RD |
City | BOISE |
State | ID |
Zip Code | 83713-3610 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417253873 | Auburn Crest Hospice Treasure Valley, LLC | Hospice Care, Community Based | 3751 N Cloverdale Rd, Boise, ID 83713-3610 | 2011-02-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
Find all providers in zip 83713 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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1932506508 | Access Behavioral Health Services, Inc | Clinic/Center | 1276 W River St, Suite 100, Boise, ID 83702-7066 | 2014-11-26 |
1568700128 | Family Care Clinic LLC | Clinic/Center | 8050 W Rifleman St Ste 100, Boise, ID 83704-9006 | 2013-01-16 |
1104177757 | Erland Internal Medicine, PC | Clinic/Center | 6023 N Eagle Rd, Boise, ID 83713-0997 | 2012-09-23 |
1184948929 | Affinity, Inc | Clinic/Center | 8100 W Emerald St Ste 150, Boise, ID 83704-9057 | 2010-03-23 |
1598929903 | Healthworks Med Group of Colorado, PC | Clinic/Center | 8000 S Federal Way # Ms 1-706, Boise, ID 83716-9632 | 2008-07-15 |
1912189481 | Emergency Responders Health Center, LLC | Clinic/Center | 9976 W Emerald St, Boise, ID 83704-9769 | 2007-11-27 |
1992741490 | Genesis Medical Center | Clinic/Center | 10255 Overland Rd, Boise, ID 83709-1430 | 2006-06-22 |
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1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
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1447801451 | Mountain Country Family Healthcare, Pllc | Clinic/Center | 31911 N 5th Ave, Spirit Lake, ID 83869 | 2019-09-23 |
1275186835 | Bella Family Healthcare & Aesthetics | Clinic/Center | 1545 E Leighfield Dr Ste 100, Meridian, ID 83646-5371 | 2019-07-22 |
1902387285 | Integrative Health Solutions Pllc | Clinic/Center | 1215 Michigan St Ste B, Sandpoint, ID 83864-5014 | 2018-08-24 |
1235618331 | Healthworks Med Group of Colorado P C | Clinic/Center | 126 E 21st St, Burley, ID 83318-2551 | 2018-08-09 |
1427537927 | Gem State Family Health Care Pllc | Clinic/Center | 496 Shoup Ave W Ste E, Twin Falls, ID 83301-5043 | 2018-08-07 |
1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
1073031118 | Clover Creek Medical | Clinic/Center | 175 North Main Street, Bloomington, ID 83223-8322 | 2017-09-08 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.